Application To Segregate Water Service

Transcription

1 Application To Segregate Water Service If two or more existing legally constructed dwellings exist on a property and are connected to a common water meter, installation of additional meter(s) may be permissible to create separate water billings. This process is called Segregation. The following applications/forms must be filled out completely. Should you have any questions, please call the Board of Water Supply Service Engineering Section, at or (1) Segregation of Service Application The Segregation of Service Application, forms an agreement between the Board of Water Supply (BWS) and the applicant, that if the property piping is incorrectly installed and problems arise, the applicant is responsible at his/her own expense to correct the problem(s). (2) New Address Certificate If the City and County of Honolulu database cannot provide registered addresses for the existing legally constructed dwellings related to the segregation, a New Address Certificate may be required as an alternative to obtain the registered addresses. The New Address Certificate is obtained from the City and County of Honolulu s Department of Planning and Permitting. (3) Billing Authorization Form This form indicates the person responsible for the water bills. NOTE: Please coordinate any building permit application requirements with the City and County of Honolulu s, Department of Planning and Permitting to accommodate the plumbing work for the segregation. REVISED October 10,

2 BOARD OF WATER SUPPLY (BWS) Application for Segregation of Services(s) Premise ID#: Segregation of Service Proper Connection Date INSTRUCTIONS FOR THE APPLICANT: 1. Provide a schematic drawing (hand-drawn is permitted), on the backside of this application with the following information: a. Plot Plan, Tax Map Key Number (TMK) b. Location of existing structures with their addresses as assigned by the Department of Planning and Permitting s House Numbering Section. c. Each structure that the existing meter is connected to. d. Existing driveway(s) and perimeter walls and/or fences. You may call us at or for assistance in drawing this sketch. 2. If there are changes to the sketch, the Applicant is responsible to inform BWS Service Engineering Section at or Any incorrect connection(s) after the meter(s) shall be corrected by the Applicant(s) at his/her cost. Please note that if the service is not connected to the proper structure, incorrect water bills will result. After the meter is installed and as a result of the changes/revisions due to incorrect connections, additional field work shall be done at the Applicant s expense. 4. BWS WILL NOT BE RESPONSIBLE FOR ANY SWITCHED SERVICES OR IMPROPER INTERCONNECTIONS ON THE CONSUMER SIDE OF THE METER. The Applicant shall be responsible to verify that the service is connected as shown on the sketch. Note: Water Systems Facilities Charges from the existing water meter will be transferred to the new water meter I, the undersigned, am responsible for the proper connection(s) and understand that if any incorrect connection(s) is/are made, BWS shall be held harmless. If corrections are not made, BWS may terminate the service(s). OWNER (print name): Signature (of owner): Res Phone: Bus Phone: Contractor/Person doing the work (if Known): Phone Number: Service Engineer: **SKETCH** (see page 4) WS-337 (REVISED June 3,2003) 2

3 If you decide to draw your own sketch, please include the items listed below: 1. Property lines. 2. Location of Houses/Structures on the lot that have plumbing fixtures. 3. Addresses of the houses (as assigned by The Department Of Planning and Permitting). 4. Location of the existing water meter that serve all of the plumbing fixtures on the lot. 5. Location for the new water meter. 6. Distance from property line for new water meter box location. 7. Existing property piping from the existing water meter to all existing structures that have plumbing fixtures on the lot. 8. Two slash lines through the existing property piping (as mentioned in item #7 above) indicating the separation from the existing water meter. 9. New property piping from the new water meter for the house and respective structures that have plumbing fixtures. 10. Existing driveway. 11. Distance from the property line to the edge of the road. 12. Type of sidewalk. (i.e. grass, concrete, dirt, asphalt, etc.) 13. Street Name that fronts the lot. 14. Tax Map Key Number for the lot. Note: Fill out one of the accompanying Fixture Unit Computation Worksheet for the dwelling(s) to be connected to the new water meter. If you need assistance in preparing the sketch, or have any questions regarding this application, please call the Service Engineering Section at ph# or REVISED January 18,

4 SAMPLE SKETCH SAMPLE SKETCH 4

5 BOARD OF WATER SUPPLY City and County of Honolulu 630 South Beretania Street Honolulu, HI Telephone: BILLING AUTHORIZATION Premise ID No. SUBDIVISION/PROJECT TAX MAP KEY LOT NO. PREMISE ADDRESS For the water service and meter at the above location, please send all water bills for payment to: CUSTOMER First name Middle Initial Last Name - or - BUSINESS NAME MAILING ADDRESS ZIP CODE The undersigned hereby agrees to pay all charges incurred upon such water service and meter at the above location and to abide by all rules, regulations, and provisions prescribed by the Board of Water Supply, City and County of Honolulu, relating to water service and/or rates. Print Name Customer s or Authorized Agent s Signature Effective Date REVISED May 1, 2007 Bus Customer s Employer Res Customer s Phone Nos. 5

6 Board of Water Supply Service Engineering Fixture Unit Computation Worksheet SFD Address EXISTING FIXTURES Quantity Regular Quantity Low Flow Total Plumbing Fixtures 1 FU.6 FU Lavatory 3 FU 1.7 FU W.C. (Tank) 1 FU 1.0 FU Bidet 2 FU 1.6 FU Tub/Shower (Combo) 2.5 FU 2.5 FU Tub or Furo Only 2 FU 1.6 FU Shower Only 2 FU 1.6 FU Kitchen Sink 1.5 FU 1.5 FU Dishwasher 1 FU 1.0 FU Bar Sink 2 FU 2.0 FU Laundry Tray 2 FU 2.0 FU Washing Machine 2.5 FU 2.5 FU Hose Bibb (1/SFD) 1 FU 1.7 Urinal Other TOTAL SFD Address EXISTING FIXTURES Quantity Regular Quantity Low Flow Total Plumbing Fixtures 1 FU.6 FU Lavatory 3 FU 1.7 FU W.C. (Tank) 1 FU 1.0 FU Bidet 2 FU 1.6 FU Tub/Shower (Combo) 2.5 FU 2.5 FU Tub or Furo Only 2 FU 1.6 FU Shower Only 2 FU 1.6 FU Kitchen Sink 1.5 FU 1.5 FU Dishwasher 1 FU 1.0 FU Bar Sink 2 FU 2.0 FU Laundry Tray 2 FU 2.0 FU Washing Machine 2.5 FU 2.5 FU Hose Bibb (1/SFD) 1 FU 1.7 Urinal Other TOTAL 6